Diabetes Insipidus DDx
- Nature: Excessive loss of hypotonic urine
- Treatment: Fluid resuscitation greater than urine output
Cause
Central (Failed ADH secretion)
- Idiopathic (30%)
- CNS (60%)
- Tumour 25%
- Pituitary surgery, Sheehan’s, panhypopituitarism (20%)
- Head trauma (15%)
- CNS infection
- CVA, Aneurysm
- Sickle cell anaemia
- Respiratory (10%) (usually granulomatous disease)
- Granulomatosis With Polyangiitis
- Sarcoidosis
- TB
- Syphilis
- histiocytosis
Nephrogenic (No response to ADH) (Failed concentrating ability)
- HYPOkalaemia, hypercalcaemia
- Renal disorders (myeloma, amyloidosis, ATN, TIN)
- Drugs as below
Drugs
- alcohol
- phenytoin
- amphotericin
- sulphonylureas
- colchicine
- gentamicin
References and Links
- CCC – Hypernatraemia
- CCC – Hypernatraemia Mind map (PDF)
- CCC – Hyponatraemia
- CCC – Hyponatraemia Mind map (PDF)
- CCC – Hyponatraemia Interpretation (PNG)
- CCC – SIADH
- CCC – Diabetes Insipidus Central
- Case – Exercise-associated Hyponatremia
- Case – Seizures, hyponatremia and ADH
[cite]
Critical Care
Compendium